Why are we less forgiving of Ralph Northam as a politician than as a doctor?

I doubt this weekend is the first time anyone has laid eyes on the racist picture published on Virginia Gov. Ralph Northam’s 1984 Eastern Virginia Medical School yearbook page. Yet over the past few decades, the offensive photograph had not created any obstacles for the doctor-turned-civil servant as he pursued a career in pediatric neurology.

Now, with the photograph being hotly debated on cable news, many politicians, including those in his own political party, are suddenly calling for Northam’s resignation, arguing that he has surrendered his moral authority as a leader and tainted his ability to govern.

Why are we less forgiving of him as a politician than we were when he was a practicing doctor?

Racial bias in medicine, either implicit or explicit, undoubtedly taints our ability to care for patients. Many studies show that it contributes to poorer treatment and health outcomes for black and minority patients compared to white patients. Yet, physicians who harbor this bias rarely get held back or suffer severe professional consequences.

When I heard the news about Northam, I was obviously horrified, but no more horrified by the image than any of the other racial injustices I’ve seen on the medical wards. I didn’t immediately agree with the calls for his resignation — and that surprised me.

I reflected on my own experiences facing bias and bigotry throughout medical training and realized that I’ve never wanted or expected any of my colleagues to be fired or kicked out of school. My wish was for each doctor or doctor-in-training to listen to feedback, apologize for their mistakes, and learn from their lapses in judgement.

Each of us has made a lifelong commitment to learning how we can best serve our patients. It’s a commitment that allows us room to exercise humility when we make mistakes and change our behavior when it both undermines the humanity of others and the promise to do no harm. I know I have grown in learning how to care for patients much different than myself, and I feel tremendous gratitude toward the people who have gracefully shown me how to do it.

This is the path Eastern Virginia Medical School took in 2013, when another racially offensive photograph was published in the school yearbook. It depicted three medical students in Confederate uniforms posed in front of a Confederate flag. As reported by the Washington Post, these students were not expelled from school, but rather offered counseling and sensitivity training.

I’m thankful medicine is a forgiving profession, but I know there is a thin line between forgiveness and failure to do anything about racism and discrimination. These issues are hard to address and so they often aren’t. Health disparities persist when no one corrects mistakes and there’s no opportunity to listen, apologize, or learn. We must face bias head on, or risk repeating our preventable mistakes.

To be a healer is to recognize that medicine is a fundamentally human enterprise — we are all flawed and make mistakes, and sometimes these mistakes can cost people their lives. Doctors don’t get “canceled” or forced to resign whenever we err. By being open about these mistakes, we can identify the root causes and work collaboratively to prevent them from causing harm again. When we know better, all of us are able to do better.

Medicine is not perfect, but I remain hopeful and open-hearted because I believe in my profession’s commitment to progress.